Blood in the semen

• pain with urination
• pain with ejaculation
• pain with bowel movement
• tenderness in scrotum
• swelling in scrotum
• swelling or tenderness in groin area
• lower back pain
• fever or chills

Common Causes:
Blood in the semen may be caused by inflammation, obstructive processes, or trauma anywhere along the male reproductive tract. It may indicate disease or a problem within the urethra, testicles , epididymis, or prostate.

Note: There may be other causes of blood in the semen. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for blood in the semen, occurring alone or in combination with other problems.

Home Care:
Treatment depends on the cause.

Minor trauma may be treated by supportive measures such as rest, ice applications, and monitoring symptoms. Major trauma may require reconstructive surgery. Some of the causes may require emotional support and psychological counseling in conjunction with other treatment.

Infections are treated with antibiotics taken by mouth (or intravenous antibiotics if symptoms are severe).

Obstructions are typically treated with surgery. If cancerous tumors are the source of obstruction, radiation and or chemotherapy may also be indicated.

Call Your Healthcare Provider If:

• there is any blood in the semen.

What to Expect:
The medical history will be obtained and a physical examination will be performed.

Medical history questions include:

• quality
  • Is the semen grossly bloody?
  • Was microscopic blood noticed when the semen was examined for another reason? What was that reason?

• time pattern
  • When was this first noticed?
  • Is it present all the time?
  • Is there anything that seems to have caused this symptom?

• other
  • What other symptoms are present?

A physical examination may be completely normal or reveal:

• fever
• enlarged or tender inguinal (groin area) lymph nodes ( swollen lymph nodes )
• scrotal swelling or tenderness
• urethral discharge
• prostate enlargement or tenderness

Diagnostic tests:

• Triple-void urine specimens are collected for urinalysis and urine culture :
  • #1 initial stream
  • #2 mid stream
  • #3 post (after) prostatic massage** by examiner

• urinalysis reveals increased white blood cells (WBCs) and bacterial growth upon culture of urine #3
• prostatic secretions contain increased levels of WBCs.

** Your health care provider may choose not to perform prostatic massage in an acute condition where the prostate is obviously swollen and tender because massage may potentially spread the infection, causing bacteremia or sepsis (generalized infection in which bacteria are present in the bloodstream, rather than localized to one specific part of the body).

After seeing your health care provider:
If a diagnosis was made by your health care provider as the cause of blood in the semen, you may want to note that diagnosis in your personal medical record.